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. 1990 Jul;80(7):853–857. doi: 10.2105/ajph.80.7.853

Risk factors for syphilis: cocaine use and prostitution.

R T Rolfs 1, M Goldberg 1, R G Sharrar 1
PMCID: PMC1404975  PMID: 2356911

Abstract

In Philadelphia, a large increase in syphilis among minority group heterosexuals began in 1986 and preceded similar increases elsewhere in the United States. To determine reasons for this increase, we conducted a case-control study in the metropolitan sexually transmitted diseases clinic during 1987 and 1988. Cocaine use (odds ratio [OR] 3.1; 95% confidence interval [95% CI] = 1.5, 6.5 among men; OR 5.8; 95% CI = 1.5, 33 among women) and exchange of drugs for sex (OR 3.5; 95% CI = 1.4, 8.7 among men) were risk factors for syphilis. Although cocaine users reported more sexual partners and more frequently reported sex with prostitutes, cocaine use remained a risk factor after adjustment for these behaviors. These data suggest that sexual behavior or another factor, such as availability or utilization of health care, among cocaine users leads to increased risk of syphilis in this population. Increases in cocaine use may be partly responsible for recent increases in syphilis incidence in the United States.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Andrus J. K., Fleming D. W., Harger D. R., Chin M. Y., Bennett D. V., Horan J. M., Oxman G., Olson B., Foster L. R. Partner notification: can it control epidemic syphilis? Ann Intern Med. 1990 Apr 1;112(7):539–543. doi: 10.7326/0003-4819-112-7-539. [DOI] [PubMed] [Google Scholar]
  2. Chaisson R. E., Bacchetti P., Osmond D., Brodie B., Sande M. A., Moss A. R. Cocaine use and HIV infection in intravenous drug users in San Francisco. JAMA. 1989 Jan 27;261(4):561–565. [PubMed] [Google Scholar]
  3. Fichtner R. R., Aral S. O., Blount J. H., Zaidi A. A., Reynolds G. H., Darrow W. W. Syphilis in the United States: 1967-1979. Sex Transm Dis. 1983 Apr-Jun;10(2):77–80. doi: 10.1097/00007435-198304000-00006. [DOI] [PubMed] [Google Scholar]
  4. Goldsmith M. F. Sex tied to drugs = STD spread. JAMA. 1988 Oct 14;260(14):2009–2009. [PubMed] [Google Scholar]
  5. Greenblatt R. M., Lukehart S. A., Plummer F. A., Quinn T. C., Critchlow C. W., Ashley R. L., D'Costa L. J., Ndinya-Achola J. O., Corey L., Ronald A. R. Genital ulceration as a risk factor for human immunodeficiency virus infection. AIDS. 1988 Feb;2(1):47–50. doi: 10.1097/00002030-198802000-00008. [DOI] [PubMed] [Google Scholar]
  6. Handsfield H. H., Rice R. J., Roberts M. C., Holmes K. K. Localized outbreak of penicillinase-producing Neisseria gonorrhoeae. Paradigm for introduction and spread of gonorrhea in a community. JAMA. 1989 Apr 28;261(16):2357–2361. [PubMed] [Google Scholar]
  7. Jaffe H. W., Rice D. T., Voigt R., Fowler J., St John R. K. Selective mass treatment in a venereal disease control program. Am J Public Health. 1979 Nov;69(11):1181–1182. doi: 10.2105/ajph.69.11.1181. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Pepin J., Plummer F. A., Brunham R. C., Piot P., Cameron D. W., Ronald A. R. The interaction of HIV infection and other sexually transmitted diseases: an opportunity for intervention. AIDS. 1989 Jan;3(1):3–9. [PubMed] [Google Scholar]
  9. Perine P. L., Handsfield H. H., Holmes K. K., Blount J. H. Epidemiology of the sexually transmitted diseases. Annu Rev Public Health. 1985;6:85–106. doi: 10.1146/annurev.pu.06.050185.000505. [DOI] [PubMed] [Google Scholar]
  10. Rosenberg M. J., Weiner J. M. Prostitutes and AIDS: a health department priority? Am J Public Health. 1988 Apr;78(4):418–423. doi: 10.2105/ajph.78.4.418. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Simonsen J. N., Cameron D. W., Gakinya M. N., Ndinya-Achola J. O., D'Costa L. J., Karasira P., Cheang M., Ronald A. R., Piot P., Plummer F. A. Human immunodeficiency virus infection among men with sexually transmitted diseases. Experience from a center in Africa. N Engl J Med. 1988 Aug 4;319(5):274–278. doi: 10.1056/NEJM198808043190504. [DOI] [PubMed] [Google Scholar]
  12. WILLCOX R. R. Prostitution and venereal disease. Proportion of venereal disease acquired from prostitutes in Asia: a comparison with France, the United Kingdom, and the United States of America. Br J Vener Dis. 1962 Mar;38:37–42. doi: 10.1136/sti.38.1.37. [DOI] [PMC free article] [PubMed] [Google Scholar]

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